It is known in the art to use dental implants to replace missing teeth in a patient's mouth using various procedures. Dental implant procedures generally involve drilling a pilot hole into the jawbone of a patient and inserting an implant body into the hole provided. The crown is then cemented to the top section of the implant abutment to complete the procedure. There are various prior art stents used as drill guides for drilling the initial pilot hole. These prior art procedures commonly require the purchase of high-tech, very expensive apparatuses. The pilot hole in an implant procedure is critical since it provides the hole into which the implant will be based and must be drilled along an acceptable path to insure maximum strength to the eventual implant. Many implant stents in use today are fabricated with thick vacuum formed plastic that covers the biting surfaces of many teeth adjacent to the surgical site. These stents, by virtue of their size and thickness above the teeth, drastically reduce access to the surgical site, especially in the posterior molar regions where the tongue and cheek muscles already reside making multiple instrumentation procedures exceedingly difficult, if possible at all.
In addition to the large stent, a directional device with a three-inch long handle is required to help direct the pilot drill. Not only does it restrict vision even further, the long “lever” easily torques the stent right or left and is difficult to hold steady when the surgeon has to hold the drill at the proper angle with one hand, hold the directional device's handle with the other, keep the stent down without twisting it left or right, all the while fighting the tongue and cheek muscles from throwing the pilot drill off line. A water syringe and suction tip are thrown into the mix, reducing vision further. It is almost impossible in these prior art procedures to see if the pilot hole and drill are accidentally sliding down outside the surface of the bone because the dentist cannot determine whether they are entering at the right spot or at the right angle. To illustrate, most of the implant placement failures and near failures involve a bony ridge on the posterior ridge. Starting a pilot hole, with a drill guide, which is 3, 4, 5, or 6 mm away from the dense bone of a bony ridge is a very difficult proposition. A high speed round bur does not always help. If the round bur, that starts the pilot hole is off line by even 0.5 mm, the implant abutment will be angled so far out of position that a premade crown may not fit properly even with a long adjustment process.
In addition, getting multiple one-piece implants (4 to 10) into their proper positions and at a 90 degree angle to the biting surface of the adjacent teeth often becomes a struggle for the surgeon and patient alike. Also, it is even more difficult to place multiple implants (4 to 10) in an extremely precise parallel arrangement when placing one-piece implants around the curves of the jaw, while remaining cognizant of the need to keep the body of the one-piece implant in the approximate middle of the jawbone's depth buccal lingually.
The severity of these problems are magnified as narrow diameter bone drills less than 1.5 mm in diameter are flexible and seldom maintain the angle desired by the operator when drilling freehand into the jawbone because the jawbone is a mixture of soft and hard tissues and air pockets. Narrow diameter bone drills also will flex away from hard tissue into the areas of least resistance, i.e., soft tissue and air pockets, rendering it very difficult to drill free-hand pilot holes at the angles intended and necessary for efficient and immediate attachment of pre-fabricated prosthetic devices, i.e., dental crowns, bridges, implant retained partials over dentures, hybrid dentures and traditional full over dentures.
Another issue is the larger diameter pilot drill bit that one-piece implant companies sell in their implant kits. These larger diameter pilot drill bits when drilling into less than dense bone often remove the very bone that would be necessary for initial implant stabilization requirements. When this happens, drops of blood bubble from the hole on a drop-by-drop basis, thereby causing the procedure to be aborted, which is expensive and bad for patient confidence.
Also, current surgical stent guide systems do not provide adequate guidance for narrow diameter pilot drill bits during a majority of its travel into and through the bony ridge because the pilot drill guide tubes, end 1 to 4 millimeters above the surface of the bone. Additionally, many of the current surgical stent guide systems are also, large with bulky associated instrumentations precluding the effectiveness in the posterior regions of the mouth where most patients require implants. Furthermore, the current surgical stent guide systems also do not work well because the tolerances used for the drill guides are so lax and the associated instrumentations are so bulky, that it is easy for the dentist to drill pilot holes outside the surface of the bone instead of drilling into the bone at the previously determined angle and depth.
Many dentists attempting to use these current surgical stent drill guide systems for one piece implants find major problems arise and become discouraged when cases fail to integrate, or are so far outside ideal position that it is impossible to place prosthetics in a good cosmetic and/or functional position. Also many other surgical stent drill guide systems are sent to a dental laboratory, where the cases are treatment planned and the initial pilot-hole penetrations are dialed into the stent by a non-dentist lab technician. Trusting a $4,000 implant case to a technician seems foolhardy at best, and may result in a failed surgery. If the stent is inaccurate, the dentist will not be able to remake the stent quickly, as it would require the dentist to send for a new stent, often taking weeks for delivery, thus the dentist will have to abort the surgery and incur additional expenses.
Another issue with the current surgical stent drill guide systems is the type of baseplate matrix material used. Numerous materials are used to make dental baseplate's, retainers, bite blocks and bruxism (grinding) stents. Most implant guide stents are made of vacuum formed clear resin sheets. These types of stents do not allow the dentist to make implant guide stents the same day as surgery. Typically, the patient must come in for a consultation where the dentist takes an impression and the patient then must leave and return on a later day for surgery when the dentist has made the implant guide stent. Also, many stents are expensive as they use such equipment as CT Scans, or three-dimensional (3D) stereo lithography techniques.
Some current surgical stent drill guide systems tried to address some of the above issues as they provided a surgical stent drill guide system, which contacted the bone at its inferior surface providing some resistance to movement as the pilot hole was created. However, these surgical stent drill guide systems did not allow for active engagement with the bony ridge as the pilot drill entered the surface of the bony ridge. Thus, these surgical stent drill guide systems did not allow for precise directional control. Also, these surgical stent drill guide systems did not allow for immediate fabrication in a few minutes and they did not allow for the stent to be made or “remade” during surgery when necessary.
Other prior art surgical stent drill guide systems require expensive computer imaging, 3D CT scans, and/or computer assisted digital x-ray images, for stent fabrication. These time consuming and expensive surgical stent drill guide systems such are the sorts of items that have kept implant dentistry out of financial reach of the average patient. These prior surgical stent drill guide systems do not (nor is it their intention) provide the accuracy necessary to cement a premade crown the same day as implant surgery.
Thus, a heretofore unaddressed need exists in the industry to address the aforementioned deficiencies and inadequacies.